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Hyde BR, Martin LG, Chen AV, Guess SC, Carrera-Justiz S, Bruyette D, Owen TJ. Clinical characteristics and outcome in 15 dogs treated with transsphenoidal hypophysectomy for nonfunctional sellar masses. Vet Surg 2023; 52:69-80. [PMID: 36416123 PMCID: PMC10100401 DOI: 10.1111/vsu.13917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 09/22/2022] [Accepted: 10/30/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To characterize the clinical features, neurological examination findings, diagnostic imaging results, histopathological findings, and outcome following transsphenoidal hypophysectomy (TSH) in dogs with nonfunctional sellar masses (NFSM). STUDY DESIGN Multi-institutional retrospective study. METHODS Medical records of dogs that underwent TSH for a NFSM were reviewed for clinical signs, physical and neurological examination findings, diagnostic imaging results, endocrine testing, surgery reports, and outcome. Magnetic resonance (MR) imaging was rereviewed, and tumors were classified using the previously described system according to pituitary tumor extension and vascular involvement. Owners of dogs that survived to discharge were contacted. RESULTS The majority of dogs presented for mentation change (12/15). The mean pituitary to brain ratio (P/B ratio) was 1.05 (0.6-1.4). Eight dogs had a tumor imaging classification of 5B. Eleven dogs were diagnosed with a nonfunctional pituitary adenoma (NFPA). Perioperative mortality was 33% (5/15). The median survival for all dogs was 232 days (0-1658). When dogs that did not survive to discharge were excluded, the median survival time was 708 days. Seven of 10 dogs that survived the perioperative period received adjunctive therapy. Owner assessment of outcome was excellent (6/7) to good (1/7). CONCLUSION The common presenting complaint for dogs with large NFSM causing mass effect was mentation changes. Dogs with NFPA that survived to discharge and received adjunctive therapy had good to excellent outcomes. CLINICAL SIGNIFICANCE Transsphenoidal debulking with adjunctive therapy can be considered for the treatment of NFSM causing clinical signs of mass effect in dogs. Successful long-term outcomes are possible.
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Affiliation(s)
- Brittany R Hyde
- Department of Veterinary Clinical Sciences and Veterinary Teaching Hospital, Washington State University, Pullman, Washington, USA
| | - Linda G Martin
- Department of Veterinary Clinical Sciences and Veterinary Teaching Hospital, Washington State University, Pullman, Washington, USA
| | - Annie V Chen
- Department of Veterinary Clinical Sciences and Veterinary Teaching Hospital, Washington State University, Pullman, Washington, USA
| | - Sarah C Guess
- Department of Veterinary Clinical Sciences and Veterinary Teaching Hospital, Washington State University, Pullman, Washington, USA
| | | | - David Bruyette
- VCA West Los Angeles Animal Hospital, Los Angeles, California, USA
| | - Tina J Owen
- Department of Veterinary Clinical Sciences and Veterinary Teaching Hospital, Washington State University, Pullman, Washington, USA
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Nakaichi M, Iseri T, Horikirizono H, Sakai Y, Itoh H, Sunahara H, Itamoto K, Tani K. Clinical features and their course of pituitary carcinoma with distant metastasis in a dog. J Vet Med Sci 2020; 82:1671-1675. [PMID: 33028750 PMCID: PMC7719888 DOI: 10.1292/jvms.20-0500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
An 11-year-old male toy poodle with neurological symptoms was diagnosed with a macroscopic pituitary tumor, which produced adrenocorticotropic hormone. Radiation therapy with a linear accelerator was performed for the pituitary tumor, and resulted in good local tumor control. However, serum endogenous adrenocorticotropic hormone concentrations were uncontrollable even after the tumor disappeared. Abdominal computed tomography revealed splenic masses, and splenectomy was performed. Histopathological examination of the surgical specimen showed tumor cells with eosinophilic and finely granular cytoplasm suggestive of endocrine origin. Since these cells were positive for adrenocorticotropic hormone, the case was diagnosed as a pituitary carcinoma with distant metastasis. Necropsy revealed multiple metastases to the abdominal organs. This is the first case report describing canine pituitary carcinoma with distant metastasis.
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Affiliation(s)
- Munekazu Nakaichi
- Department of Veterinary Radiology, Joint Faculty of Veterinary Science, Yamaguchi University, Yamaguchi, Yamaguchi 753-8515, Japan
| | - Toshie Iseri
- Department of Veterinary Radiology, Joint Faculty of Veterinary Science, Yamaguchi University, Yamaguchi, Yamaguchi 753-8515, Japan
| | - Hiro Horikirizono
- Department of Veterinary Radiology, Joint Faculty of Veterinary Science, Yamaguchi University, Yamaguchi, Yamaguchi 753-8515, Japan
| | - Yusuke Sakai
- Department of Veterinary Pathology, Joint Faculty of Veterinary Science, Yamaguchi University, Yamaguchi, Yamaguchi 753-8515, Japan
| | - Harumichi Itoh
- Department of Veterinary Small Animal Clinical Science, Joint Faculty of Veterinary Science, Yamaguchi University, Yamaguchi, Yamaguchi 753-8515, Japan
| | - Hiroshi Sunahara
- Department of Veterinary Surgery, Joint Faculty of Veterinary Science, Yamaguchi University, Yamaguchi-shi, Yamaguchi 753-8515, Japan
| | - Kazuhito Itamoto
- Department of Veterinary Small Animal Clinical Science, Joint Faculty of Veterinary Science, Yamaguchi University, Yamaguchi, Yamaguchi 753-8515, Japan
| | - Kenji Tani
- Department of Veterinary Surgery, Joint Faculty of Veterinary Science, Yamaguchi University, Yamaguchi-shi, Yamaguchi 753-8515, Japan
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Soler Arias EA, Trigo RH, Gomez Alvarez CM, Castillo VA. Vestibular dysfunction due to thalamic metastasis of a corticotropic carcinoma in a dog. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Elber Alberto Soler Arias
- U. EndocrinologíaHosp Esc Med VetCat.Clin Med Peq AnimalesFac Ciencias VeterinariasUniversidad de Buenos AiresCiudad Autónoma de Buenos AiresBuenos AiresArgentina
| | - Roberto Hector Trigo
- Catedra de PatologíaFac Ciencias VeterinariasUniversidad de Buenos AiresCiudad Autónoma de Buenos AiresBuenos AiresArgentina
| | | | - Víctor Alejandro Castillo
- U. EndocrinologíaHosp Esc Med VetCat.Clin Med Peq AnimalesFac Ciencias VeterinariasUniversidad de Buenos AiresCiudad Autónoma de Buenos AiresBuenos AiresArgentina
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Polledo L, Grinwis GCM, Graham P, Dunning M, Baiker K. Pathological Findings in the Pituitary Glands of Dogs and Cats. Vet Pathol 2018; 55:880-888. [DOI: 10.1177/0300985818784162] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
With the exception of classic functional adenomas in dogs and horses, pituitary lesions are infrequently described in the veterinary literature. Approximately 10% of pituitary glands from asymptomatic humans contain abnormalities, but the equivalent proportion in small animals is unknown. Pituitary glands from 136 dogs and 65 cats collected during routine necropsies were examined to determine the prevalence of pituitary lesions and their histopathological diagnosis. Lesions were characterized in sections stained with hematoxylin and eosin, periodic acid-Schiff (PAS), Gordon and Sweet’s and reticulin stains, and immunohistochemistry for adrenocorticotropic hormone (ACTH), growth hormone, melanocyte stimulating hormone–α, and prolactin. Pituitary abnormalities were identified in 36 of 136 (26.4%) dogs and 10 of 65 (15.3%) cats. Cystic changes were the most common lesion, occurring in 18 (13.2%) dogs and 8 (12.3%) cats. Pituitary neoplasia was detected in 14.1% (12/85) of middle-aged and old dogs; 1 (1.5%) cat had pituitary nodular hyperplasia. PAS and reticulin stains helped differentiate ACTH-immunoreactive adenomas from hyperplastic nodules: adenomas contained PAS-positive intracytoplasmic granules and loss of the normal reticulin network. One dog had a pituitary carcinoma with infiltration into the thalamus. Other pituitary abnormalities included secondary metastases (2 dogs) and hypophysitis (4 dogs, 1 cat). In most cases, the lesion appeared to be subclinical and could be considered incidental, whereas clinical manifestations were apparent in only 4 dogs (2.9%) and none of the cats with pituitary lesions. Pituitary abnormalities are common in dogs and cats, and their clinical relevance requires further investigation.
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Affiliation(s)
- Laura Polledo
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | - Guy C. M. Grinwis
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht, the Netherlands
| | - Peter Graham
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | - Mark Dunning
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | - Kerstin Baiker
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
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Miller MA, Bruyette DS, Scott-Moncrieff JC, Owen TJ, Ramos-Vara JA, Weng HY, Vanderpool AL, Chen AV, Martin LG, DuSold DM, Jahan S. Histopathologic Findings in Canine Pituitary Glands. Vet Pathol 2018; 55:871-879. [PMID: 29665752 DOI: 10.1177/0300985818766211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To optimize the histologic evaluation of hypophysectomy specimens, sections of 207 canine pituitary glands (196 postmortem, 11 hypophysectomy specimens) were reviewed. Adenohypophyseal proliferation was the most common (n = 79) lesion. Proliferative lesions were sparsely to densely granulated; the granules were usually basophilic to chromophobic and periodic acid-Schiff-positive. Adenohypophyseal proliferation was classified as hyperplasia (n = 40) if ≤2 mm diameter with intact reticulin network, as microadenoma (n = 22) for 1–5 mm homogeneous nodules with lost reticulin network, or as macroadenoma (n = 17) for larger tumors. Craniopharyngeal duct cysts were common incidental lesions and the only lesion in 15 dogs. Uncommon diagnoses included lymphoma (n = 4), hemorrhagic necrosis (n = 4), metastatic carcinoma (n = 3), hypophysitis (n = 3), ependymoma (n = 2), craniopharyngioma (n = 2), and 1 case each of metastatic melanoma, pituicytoma, gliomatosis, germ cell tumor, meningioma, and atrophy. The pituitary histologic diagnosis was associated with hyperadrenocorticism (HAC; P < .001) and adrenocortical histologic diagnosis ( P = .025). Both HAC and adrenocortical hyperplasia showed a positive trend with the degree of adenohypophyseal proliferation. The association of adrenocortical hyperplasia with HAC was not significant ( P = .077). Dogs with adenohypophyseal proliferations were older than dogs with normal pituitary glands ( P < .05). Brachycephalic breeds were overrepresented among dogs with pituitary macroadenoma or craniopharyngeal duct cysts, but the association was not statistically significant ( P = .076). Adenohypophyseal hyperplasia was more common than adenoma among postmortem specimens, but was unexpected in >80% of cases. Pituitary macroadenoma was the most common diagnosis in hypophysectomy specimens.
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Affiliation(s)
- Margaret A. Miller
- Indiana Animal Disease Diagnostic Laboratory, Purdue University, West Lafayette, IN, USA
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, USA
| | | | - J. Catharine Scott-Moncrieff
- Department of Veterinary Clinical Sciences and Veterinary Teaching Hospital, Purdue University, West Lafayette, IN, USA
| | - Tina Jo Owen
- Department of Veterinary Clinical Sciences and Veterinary Teaching Hospital, Washington State University, Pullman, WA, USA
| | - José A. Ramos-Vara
- Indiana Animal Disease Diagnostic Laboratory, Purdue University, West Lafayette, IN, USA
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, USA
| | - Hsin-Yi Weng
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, USA
| | - Andrea L. Vanderpool
- Indiana Animal Disease Diagnostic Laboratory, Purdue University, West Lafayette, IN, USA
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, USA
| | - Annie V. Chen
- Department of Veterinary Clinical Sciences and Veterinary Teaching Hospital, Washington State University, Pullman, WA, USA
| | - Linda G. Martin
- Department of Veterinary Clinical Sciences and Veterinary Teaching Hospital, Washington State University, Pullman, WA, USA
| | - Deidre M. DuSold
- Indiana Animal Disease Diagnostic Laboratory, Purdue University, West Lafayette, IN, USA
| | - Sina Jahan
- Department of Internal Medicine, Small Animal Hospital of Veterinary Faculty, University of Tehran, Tehran, Iran
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van Rijn SJ, Hanson JM, Zierikzee D, Kooistra HS, Penning LC, Tryfonidou MA, Meij BP. The prognostic value of perioperative profiles of ACTH and cortisol for recurrence after transsphenoidal hypophysectomy in dogs with corticotroph adenomas. J Vet Intern Med 2015; 29:869-76. [PMID: 25959680 PMCID: PMC4895417 DOI: 10.1111/jvim.12601] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 03/04/2015] [Accepted: 03/23/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Transsphenoidal hypophysectomy is an effective treatment for dogs with pituitary-dependent hypercortisolism (PDH). However, long-term recurrence of hypercortisolism is a well-recognized problem, indicating the need for reliable prognostic indicators. OBJECTIVES The aim of this study was to evaluate the prognostic value of perioperative plasma ACTH and cortisol concentrations for identifying recurrence of hypercortisolism after transsphenoidal hypophysectomy. ANIMALS A total of 112 dogs with PDH that underwent transsphenoidal hypophysectomy met the inclusion criteria of the study. METHODS Hormone concentrations were measured preoperatively and 1-5 hours after surgery. Both absolute hormone concentrations and postoperative concentrations normalized to preoperative concentrations were included in analyses. The prognostic value of hormone concentrations was studied with Cox's proportional hazard analysis. RESULTS Median follow-up and disease-free period were 1096 days and 896 days, respectively. Twenty-eight percent of patients had recurrence, with a median disease-free period of 588 days. Both absolute and normalized postoperative cortisol concentrations were significantly higher in dogs with recurrence than in dogs without recurrence. High ACTH 5 hours after surgery, high cortisol 1 and 4 hours after surgery, high normalized ACTH 3 hours after surgery, high normalized cortisol 4 hours after surgery and the random slope of cortisol were associated with a shorter disease-free period. CONCLUSIONS AND CLINICAL IMPORTANCE Individual perioperative hormone curves provide valuable information about the risk of recurrence after hypophysectomy. However, because no single cutoff point could be identified, combination with other variables, such as the pituitary height/brain area (P/B) ratio, is still needed to obtain a good estimate of the risk for recurrence of hypercortisolism after hypophysectomy.
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Affiliation(s)
- S J van Rijn
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - J M Hanson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - D Zierikzee
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - H S Kooistra
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - L C Penning
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - M A Tryfonidou
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - B P Meij
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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Sharman M, FitzGerald L, Kiupel M. Concurrent somatotroph and plurihormonal pituitary adenomas in a cat. J Feline Med Surg 2013; 15:945-52. [DOI: 10.1177/1098612x13483461] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
An 8-year-old, male neutered, domestic longhair cat was referred for investigation of insulin-resistant diabetes mellitus. Routine haematology, serum biochemistry, urinalysis (including culture), total T4 and urine creatinine:cortisol ratio were unremarkable, but markedly increased insulin-like growth factor-1 concentration was identified and a pituitary mass was subsequently documented. The cat was treated conservatively with the dopamine agonist L-deprenyl and was re-presented 16 months later for worsening polyuria, polydipsia, polyphagia, marked lumbar muscle atrophy, development of a pendulous abdomen and marked thinning of the abdominal skin. Hyperadrenocorticism was diagnosed based on abdominal ultrasonography, dexamethasone suppression testing and endogenous adrenocorticotropic hormone (ACTH). The cat was treated with trilostane (30 mg q24h PO) and showed some clinical improvement, but developed an opportunistic fungal infection and skin fragility syndrome 4.5 months after commencing treatment, and was euthanased. A double-pituitary adenoma comprising a discrete somatotroph adenoma and a separate plurihormonal adenoma (positive immunoreactivity for ACTH, melanocyte-stimulating hormone and follicle-stimulating hormone) was identified on post-mortem examination. These two pituitary adenomas were suspected to have arisen as independent neoplastic entities with the plurihormonal tumour either being clinically silent at the initial presentation or having developed over the subsequent 16 months.
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Affiliation(s)
- Mellora Sharman
- Department of Veterinary Clinical Sciences, School of Veterinary and Biomedical Sciences, Murdoch University, Murdoch, WA, Australia
- Faculty of Veterinary Science, University of Melbourne, Werribee, VIC, Australia
- Mellora Sharman is currently affiliated with the Faculty of Veterinary Science, University of Melbourne, Werribee, VIC, Australia
| | - Louise FitzGerald
- Department of Veterinary Clinical Sciences, School of Veterinary and Biomedical Sciences, Murdoch University, Murdoch, WA, Australia
- Louise FitzGerald is currently affiliated with the Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Matti Kiupel
- Diagnostic Center for Population and Animal Health, Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
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